Michael Jackson Autopsy Results

June 27, 2009 — admin

Michael Jackson’s autopsy shouldn’t be a surprise. California law requires an autopsy for all violent, sudden or unusual deaths, or deaths resulting from a criminal act, says Steve Gelman of the San Francisco City and County Medical Examiner’s office.

A pathologist from the Los Angeles County Medical Examiner’s office would perform the autopsy. The pathologist is aided by a diener, the technical term for an autopsy assistant (from the German word Leichendiener, which literally means “corpse servant.”)

The diener helps open the body and remove the organs, while the actual dissection is done by the pathologist.

In routine cases the autopsy itself might be conducted by pathology residents and fellows on rotation from Los Angeles area medical schools. However, in a high profile case such as this one the medical examiner’s pathologists would most likely do it, says Michael Fishbein, chief of autopsy service and a professor of pathology and medicine at the David Geffen School of Medicine at UCLA.

Some websites are reporting that Lakshmanan Sathyavagiswaran,the county’s Chief Medical Examiner who was also a star witness in the O.J. Simpson case, is performing the procedure.

So what are the steps involved in an autopsy?

A full autopsy generally takes between two and three hours. Tissue samples for microscopic examination take a day or two to prepare. Toxicology testing on blood and urine can take up to three weeks, Fishbein says.

In any autopsy, but especially one in an individual in his 50s with no obvious cause of death, the first step would be to do an external examination, says Fishbein.

“You look for evidence of trauma and take blood and urine samples” for toxicology tests, which would find evidence of drugs or poison in the body. DNA testing might also be performed.Sometimes vitreous humor, the gel from the interior of the eyeball, is also retrieved, as chemical changes that might taint results from other fluids occur more slowly there.

If drug overdose is suspected, specimens of liver, brain and perhaps fat tissue would also be taken, depending on where

the suspected drugs tend to be deposited.

Then the body is opened, by making a Y-shaped incision on the chest, going down into the abdomen.

Next “you basically take out all the organs and look at them,” says Fishbein.

In addition, examiners remove the brain to check for trauma, skull fractures or aneurysms (bleeding.)

Next pathologists examine the lungs for possible lung disease or blood clots that might have restricted blood flow. “That’s a common cause of death in people who are chronically debilitated or have had recent surgery, or people who’ve had a long airplane flight, so that wouldn’t be that high (on the priorty list) in this case,” Fishbein says.

In the case of a drug overdose that resulted in depressed breathing and death, there might be some fluid in the lungs. However “if there’s been a resuscitation attempt, they’ve started an IV, so you couldn’t be able to tell,” because an IV infuses so much liquid into the body that it can collect in the lungs, Fishbein says.

Next, the heart would be removed and examined, along with the blood vessels leading to it. In general, “the heart is going to be the leading cause of a sudden death,” Fishbein says. The most common causes would be hardening of the arteries and the pathologist would check the coronary artery for blockage.

However in someone who’s been under medical care, it’s unlikely that this would have gone undetected.

Electrical system problems in the heart are also possible, but generally wouldn’t show up on an autopsy. These are often genetic, so a medical history might reveal other families members who also fell victim to sudden death.

Another potential cause of death would be a ruptured aorta, like the one that killed actor John Ritter. In that case, the massive bleeding into the chest would make it obvious. This can occur because of trauma, high blood pressure or other damage to the vessels leading to the heart.

Next the heart would be weighed, to see if it was enlarged. Viral infections and other disease processes can cause enlargement, making the heart pump less well and potentially causing it to stop.

After that, examiners look over the organs and interior of the abdomen. One thing they look for is blood. A blood vessel rupture anywhere can cause a person to bleed to death internally.

For example, an ulcer can erode a blood vessel and cause the person to “bleed to death into the gastrointestinal tract,” says Fishbein.

Pathologists would then examine the liver, spleen, intestine and kidneys, though most diseases involving these organs would not cause sudden, unexplained death, he says.

At this point, the autopsy is finished. If nothing that was an obvious cause of death was found, it is termed a negative autopsy.

In that case, the two most obvious causes of death would be drug related or a primary arrhythmia of the heart, which causes the heart to lose the ability to beat in rhythm.

Two other unlikely possibilities would be “something like foul play, where someone injected air (into a vein) or suffocated someone with a pillow,” says Fishbein. While neither would leave a mark, he notes that at this point “you’re in the realm of a TV movie.”

In addition, examiners would take tissue samples from the brain, liver and elsewhere and mount them on slides for microscopic inspection. It can take several days for the tissue to be fixed with formaldehyde to keep it from decaying, then encased in paraffin, thinly sliced and mounted on microscope slides.

Finally, the toxicology testing that would show drug residue in the body is sent to the lab. This can take weeks to get back, depending on the tests ordered.

In Feinbein’s experience, “if you hear the autopsy is negative, then it’s probably drug related or a primary arrhythmia.” However because Mr. Jackson exercised, apparently had no family history of early death and was under the care of a physician, arrhythmia seems less likely, he says.

At the end of the autopsy, the organs would be placed back in the body, if the family had requested it, and the incisions closed. The body could be prepared for an open casket funeral and no one who attended would know it had been performed, Fishbein says.